The PCT said an independent clinical review into Serco ‘has shown that in a small number of cases computer records were changed and there was insufficient justification for those changes’.

Serco had previously been investigated by the Care Quality Commission (CQC) and was ordered to improve its services.

Cornwall and Isles of Scilly LMC chairman Dr Peter Merrin said local GPs were unhappy that the PCT had removed the LMC from the out-of-hours services monitoring process.

‘This extinguishes a potentially crucial source of independent oversight from local doctors that they feel would have benefited the safety and quality of local patient care.’

‘The clinical commissioning group (CCG) must look to rectify this problem before it takes responsibility for local services,’ he said.

Dr Merrin said it was encouraging that the recent CQC evaluation and an independent local report by former primary care czar Dr David Colin-Thomé had acknowledged concerns and 'made sensible recommendations for the future'.

'It is particularly pleasing that Serco, the company with responsibility for out-of-hours care, has taken steps to resolve some of the shortcomings regarding staffing of the service,' he added. 'However, it appears that some of the important lessons from this issue have not been learned.'

Paul Forden, managing director of Serco’s clinical healthcare business, welcomed the reports. He said: 'As Dr Colin-Thomé’s report states: "I did not find any evidence that the current out-of-hours service is or has been systematically clinically unsafe". 'The report also acknowledges that we have put in place an action plan to address all the issues raised in the earlier CQC report.

'This is making excellent progress and all the required actions will be complete by the end of this month. We are pleased that our service continues to be highly rated in independent patient surveys.'

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